Operating handle for spring guides

ABSTRACT

A rotating and tip deflecting handle for spring guides, having a generally cylindrical handle portion, including a hand grip, an intermediate assembly and a carriage slidable with respect to the handle portion, means in each of said relatively slidable portions for engaging, respectively, the guide wire or the core wire, and the parts of said portions in which said engaging means are located being rotatable with respect to said hand grip. Modifications of the handle design adapt it for use with the slightly differing spring guides of various manufacturers.

United States Patent 11 1 1111 3,847,140

Ayella Nov. 12, 1974 OPERATING HANDLE FOR SPRING 3,521,620 7/1970 c001; l28/2.05 R

GUIDES 3,552,384 1/1971 Pierie et al 128 205 R Inventor: Robert J. Ayella, Lutherville, Md.

United States Catheter & Instrument Corporation, Glens Falls, NY.

Filed: Dec. 16, 1971 Appl. No.: 208,583

Assignee:

U.S. Cl. 128/2 M, l28/DlG. 9, l28/2.05 R Int. Cl. A61m 25/00, A6lb 05/02 Field of Search 128/2 M, 2.05 R, 348-351,

l28/356, 303 R, DIG. 9

References Cited UNITED STATES PATENTS 7/1969 Muller l28/2 M 3/1970 Almen 128/2 M Primary E.\'aminerDalton L. Truluck Attorney, Agent, or FirmWalter G. Finch [57] ABSTRACT A rotating and tip deflecting handle for spring guides. having a generally cylindrical handle portion, including a hand grip, an intermediate assembly and a carriage slidable with respect to the handle portion, means in each of said relatively slidahle portions for engaging, respectively, the guide wire or the core wire, and the parts of said portions in which said engaging means are located being rotatable with respect to said hand grip. Modifications of the handle design adapt it for use with the slightly differing spring guides of various manufacturers.

14 Claims, 14 Drawing Figures PAIENIEU um 12 um SHEU 1 or 3 INVENTOR ROBERT J. AYELLA TORNEY PAIENIEDImv 12 m4 SHEET 20F 3 INVENTOR ROBERT J4 AYELLA I A? I n A'F TORNEY Blair/L140 SHEEI 30F 3 PATENTEDm 12 1914 NTDFH ENI; 0 Q" mTUFm i GHM INVENTOR ROBERT J. AY ELLA BY Z 2 L 4145 /e?1-v7 ATTORNEY 1 OPERATING HANDLE FOR SPRING GUIDES With the advent of spring guides, comprising a tubular guide body and provided with a core or control wire to effect controllable curvature and straightening of the guide tip, there arose the need for handles adapted for manipulation of the guide bodies and their core wires. Muller US. Pat. No. 3,452,740 shows a Spring Guide Manipulator intended for operation of the spring guide disclosed in Muller US. Pat. No. 3,452,742. Cook US. Pat. No. 3,521,620 shows both a spring guide and a handle therefor, as does Pierie et a]. US. Pat. No. 3,552,384. These patents and the references cited therein set forth the background of the present invention and also illustrate the variations in spring guide details which neccessitate the provision of modifications in the handle to adapt it for use with the Muller guide (Muller '740, FIGS. 7 and 8), the Cook guide (Cook FIG. or the A.I-I.S.C. guide (Pierie FIGS. 13 and 14), for instance.

The handle disclosed herein has the basic elements identified in the Abstract and present in the Muller handle but simplified in construction and operation, and arranged for very convenient manipulation.

Practical embodiments of the invention are shown in the accompanying drawings, wherein:

FIG. 1 represents a side view, in slight perspective, of a first form of spring guide operating handle with the proximal end portion of a spring guide mounted therein;

FIG. 2 represents an axial section on the line IIII of FIG. 1, on a reduced scale;

FIG. 3 represents an enlargeditransverse section on the line III-III of FIG. 2;

FIG. 4 represents an enlarged transverse section on the line IV-IV of FIG. 2;

FIG. 5 represents a side view, in slight perspective, of a second form of spring guide operatinghandle with the proximal end portion of a spring guide mounted therein;

FIG. 6 represents an axial vertical section showing the handle of FIG. 5 on a reduced scale;

FIG. 7 represents a transverse section on the line VII- VII of FIG. 6;

FIG. 8 represents a transverse section on the line VIII-VIII of FIG. 6;

FIG. 9 represents a transverse section on the line IXIX of FIG. 6.

FIG. 10 represents a side view, in slight perspective, of a form of spring guide operating handle with the proximal end portion of a spring guide mounted therein;

FIG. 11 represents an axial section in the plane of the drawing showing the handle of FIG. 10, on a reduced scale;

FIG. 12 represents a detail bottom plan view of a portion of the handle shown in FIG. 11;

FIG. 13 represents a transverse section on the line XIIIXIII of FIG. 11;

FIG. 14 represents a transverse section on the line XIVXIV of FIG. 11;

Referring to FIGS. 1 to '4, the handle assembly includes the hand grip l, the rotatable core 2, the slidable carriage 3, and the adjuster 4. The hand grip is a solid cylinder having an axial bore 5 extending in from its distal end and a set screw 6 the end of which can be normally projected slightly into said bore.

The core 2 comprises a cylindrical end portion 7 fitting freely within the bore 5 and provided with an annular groove 8 into which the end of the set screw 6 can be projected to hold the core portion 7 in the bore while permitting relative rotation of the core and hand grip. The middle portion of the core is in the form of a block 9 with a hole 10 drilled radially to a distance beyond the axis of the core portion 7. The distal end portion of the core is a rod 11, coaxial with the end portion 7, provided with a first longitudinal groove 12 on its upper surface and with a second longitudinal groove 13 on one side. The groove 12 has a depth such that its bottom is slightly below the common axis of the core end portions, and the groove communicates with the hole 10 by means of a slot 14 cut in the distal wall of the block 9. Said block is bored, adjacent the slot 14 and perpendicularly to the medial plane of the hole 10 and groove 12, to receive a set screw 15 having a knurled head and an inner end which can be projected into the side of slot 14.

The slidable carriage 3 includes the cylindrical body portion 16 and the integrally formed wheel 17, the wheel and about half of the body being traversed axially by a bore 18 of a size to fit over the end portion 11 of the core 2 and to be axially slidable thereon. The adjusting screw 19 extends radially through a side wall of the wheel (FIG. 3) and is provided with a small lug 20 on its inner end, adapted to engage freely in the groove 13 to prevent rotation of the carriage 3 relative to the core 2 while permitting, normally, relative longitudinal movement. Part of the upper surface of the body portion 16 is cut away, adjacent the wheel, to provide a flat land 21, substantially coextensive with the bore 18. The distal end portion of the body 16 is provided with bore 22, coaxial with the bore 18, to receive the adjuster 4.

An open slot 23 extends the entire length of the body portion 16 communicating with an upward extension 24 of the bore 18 within the wheel 17, the slot 23 being enlarged laterally at a point 25 adjacent the wheel and at a point 26 adjacent the distal end of the land 21. Immediately proximal of the point 26 the bores 18 and 22 are separated by a partition 27, grooved downward to a depth just below the axis of the body 16. I

The adjuster 4 comprises a rod section 29, of a size to fit freely in the bore 22, and an enlarged head section 30, the rod section being traversed by a small bore 31 and the head section having a distally open larger bore 32. An adjusting screw 33 in the side of the body 16 near its distal end is tightened against the rod section 29 in any axially adjusted position of the latter (the rotational adjustment of the adjuster 4 being generally indifferent). The set screw 34 in the head 30 is adapted to engage the stop-cock (not shown) of a catheter which may be fitted over the spring guide to which the handle is attached.

In use, the controllable tip spring guide 35 has its proximal end passed through the bore 31, after which the end lug 36 on the control wire 37 is engaged in the hole 10 of the core 2 and the lug 38, on or near the proximal end of thespring guide is engaged in the carriage 3 by insertion through the opening 26 to lie on the axis of the carriage body in engagement with the distal face of the partition 27. The lug 36 is held in position by tightening the set screw 15 against the wire where r it passes through the slot 14. The lug 38 has no tendency to lift out of the slot 23 and so needs no additional securement. When the fitting on the guide wire is elongated, with lugs at each end, the proximal lug (not shown) is received in the enlarged slot 25 and the distal lug 38 in the opening 26, as described. If a catheter is carried by the spring guide, its proximal end may be engaged in the adjuster 4 which can be moved to and secured in different axial positions according to the length of the catheter.

In order to manipulate the spring guide tip, the hand grip I is held by the operator in one hand with the wheel 17 between the thumb and fore-finger. Sliding the wheel away from the hand grip pushes the spring guide forward in relation to the control wire and thus changes the curvature of the spring guide tip, while its orientation can be changed by rotating the wheel relatively to the hand grip. If a particular degree of curvature is to be maintained for a short or longer time, the screw 19 may be tightened in order to prevent, temporarily, relative axial movement of the carriage 3 on the core 2. r

The second form of spring guide handle, shown in FIGS. to 9, comprises a hand grip 40, a rotatable support assembly 41 and a slidable carriage 42. The hand grip 40 is similar to the hand grip 1, being a solid cylinder with an axial bore 43 and set screw 44 corresponding to the bore 5 and screw 6.

The support assembly 41 comprises a mounting plug 45 of T-shaped axial section, the stem 46 being freely rotatable in the bore 43 and having an annular groove 47 adapted to receive the end of screw 44 which holds the plug in. the bore while permitting relative rotation. The enlarged head 48 has a diameter greater than that of the hand grip and is knurled to facilitate manual rotation. A rod 49 has its proximal end 50 securely fixed in the head 48, eccentrically thereof, and its distal end 51 carries the spring guide mounting block 52.

The'block 52 is generally rectangular, with a bore 53 extending from end to end, and with a slot 54 extending inward from one of its narrower sides, the slot 54 having a wider chamber 55 between narrow distal and proximal portions 56, 57. The end 51 of rod 49 on which block 52 is mounted is flattened at one side 58 (FIG. 7) and the set screw 59in a side wall of the block can be tightened against said flat side to hold the block firmly in place. Between the head 48 and the block 52 the top of the rod 49 is flattened, as shown at 60, and a longitudinal groove 61 may also be formed in the bottom of the rod (as viewed in the drawing).

The carriage 42 is also in the form of a rectangular block having a bore 62 extending from end to end, the bore being of a size to receive in free sliding relationship the rod 51. In the upper distal end of the carriage there is a vertical slot 63 having a narrowed slit 64 in the distal face of the block. A set screw 65 is threaded in the top surface of the carriage and engageable with the flat area 60 along the top of rod 49, and a trigger 66 is screwed into the bottom of the block, with a lug 67 projecting freely into the groove 61, whereby relative rotation of the carriage and rod is prevented independently of the set screw 65.

In use, the handle of FIGS. 5 to 9 is mounted on a controllable tip spring guide by placing the end lug 68 of the control wire in the slot 63 with the adjacent wire passing through the slit 64. The proximal end fitting '69 of the spring guide is placed in the chamber 55 with adjacent portions of the guide and control wire passing through the narrow slot portions 56, 57, and the fitting is held firmly in place by means of the set screw 70 in the side of the block 52, opposite from screw 59, the H screw having a tapered inner end 71 for wedging the fitting 69 against the bottom of the chamber 55. The slots 63 and 54 are of a depth such that the spring guide lies on the axis of rotation of the plug 45 in the hand grip 40. When this handle is held in one hand of the operator, the plug 45 and all the elements mounted thereon can be rotated by the thumb alone or thumb and forefinger acting on the knurled head 48, and the curvature of the spring guide tip can be varied by pulling on the trigger 66 to slide the carriage 42 away from the block 52, or pushing the trigger to bring the carriage and block closer together, thus varying correspondingly the relative positions of the lug 68 and fitting 69.

In the third form, shown in FIGS. 10 to 14, all the parts are substantially the same as just described in reference to FIGS. 5 to 9, except that the guide mounting block 72 is formed with an integral distal extension 73 having a bore 74, coxial with the axis of rotation of the rotatable elements, and adapted to receive an adjuster 75,- similar in form and purpose to the adjuster 4 of FIGS. 1 to 4. The adjuster 75 may be held in any desired position by means of the set screw 76, corresponding to screw 33, and a set screw 77 is provided in the enlarged head portion 78 of the adjuster for the purposes described in reference to screw 34. FIG. 12 shows clearly, from a different point of view, the manner of attaching the spring guide fitting 79 and control wire lug 80, as shown and described in connection with fitting 69 and lug 68. FIGS. 10 to 14 also illustrate the fact that these handles can be held in various rotational positions according to the personal judgment and convenience of the operator in any given circumstances.

What I claim is:

l. A handle for a flexible, elongated controllable tip spring guide having a tubular guide body and a core wire projecting from the proximal end of said guide body said handle comprising:

a hand grip located at a first, proximal end of the handle, said hand grip having circumferential and axial dimensions such that said hand grip can be held substantially within the palm of the hand of an operator;

an intermediate assembly rotationally and nonslidably mounted in a generally coaxial relationship with the hand grip, the intermediate assembly including a core having at a first, proximal end thereof a cylindrical end portion rotatably engaged in the distal end of the hand grip, the core further having a middle block portion and a distal rod portion coaxial with the cylindrical end portion, the distal rod portion extending axially of the hand grip, the rod portion being longitudinally grooved,

said block portion having a radially disposed hole in the plane of said groove, and said hole being connected to said groove by a slit narrower than the diameter of said hole whereby a lug on the end of one of said guide body and a core wire can be retained within said hole with the core wire passing through said slit and said groove;

means on the intermediate assembly for retaining the spring guide along the axis of said handle such that the distal end of said spring guide extends beyond the distal end of the rod portion of the core;

' means mounted on said intermediate assembly for rotationally positioning said intermediate assembly; and,

a slidable carriage slidably and non-rotationally mounted on the intermediate assembly so as to permit axial positioning of said carriage on said assembly, said slidable carriage having means for engaging the other one of said guide body and core wire.

2. A handle according to claim 1 wherein at least one of said guide body and wire engaging means includes a radially open slot having wider and narrower portions.

3. A handle according to claim 1 which includes, at its distal end, an adjuster element movable axially of the handle and provided with means for securement in different axially adjusted positions.

4. A handle according to claim 1 wherein the means for positioning the intermediate assembly comprises a wheel-like member axially spaced from the hand grip so as to permit rotation of the wheel-like member by the thumb and forefinger of said operator.

5. A handle according to claim 1 wherein the slidable carriage is non-rotatably mounted on the distal rod portion of the core. 3

6. A handle according to claim 5 wherein the slidable carriage is provided with a longitudinal slot in register with the groove in the rod portion, said slot terminating distally adjacent a slitted abutment adapted to bear against a lug on the proximal end of the tubular guide body.

7. A handle according to claim 6 which includes an adjuster element slidable engaged with a distal end portion of the carriage and provided with means for securement in different axially adjusted positions.

8. A handle assembly according to claim 1 and including means on the intermediate assembly for engaging one of said guide body and core wire.

9. A handle for a flexible, elongated controllable tip spring guide having a tubular guide body and a core wire projecting from the proximal end of said guide body, said handle comprising:

a hand grip located at a first, proximal end of the handle, said hand grip having circumferential and axial dimensions such that said hand grip can be held substantially within the palm of the hand of an operator;

an intermediate assembly including a mounting plug rotationally and non-slidably mounted at a first, proximal end in a generally coaxial relationship at the distal end of said hand grip, the intermediate assembly further including a rod having a first, proximal end fixed in the second, distal end of said plug eccentrically thereof, the second, distal end of said rod extending axially beyond said plug and having mounted on said distal end a guide body mounting block, said guide body mounting block having means for providing a rigid attachment to said rod;

means on the intermediate assembly for engaging one of said guide body and core wire;

means on the intermediate assembly for retaining the spring guide along the axis of said handle such that the distal end of said spring guide extends beyond the distal end of said intermediate member;

means mounted on the intermediate assembly for rotationally positioning said intermediate assembly; and,

a slidable carriage slidably and non-rotatably mounted on the rod of the intermediate assembly between said plug and said guide body mounting block so as to permit axial positioning of said carriage on said assembly, the slidable carriage having means for engaging the other one of said guide body and core wire.

10. A handle according to claim 9 wherein the guide body mounting block is traversed from end to end by a slot.

11. A handle according to claim 10 wherein said slot is formed with an enlarged chamber to receive the proximal end fitting of a guide body, said chamber being bounded proximally and distally by narrowed parts of said slot adapted to restrain said fitting from axial movement out of said chamber.

12. A handle according to claim 9 which includes a trigger fixed in said carriage and projecting therefrom, said trigger being shaped and positioned for convenient operation by the operators finger to slide the carriage axially toward or away from the hand grip.

13. A handle according to claim 9 in which the guide body mounting block is formed with a distally extending portion, said adjuster element being provided with means for securement in different axially adjusted positrons.

14. A handle according to claim 9 wherein the means for positioning the intermediate assembly comprises a wheel-like member axially spaced from the hand grip so as to permit rotation of the wheel-like member by the thumb and forefinger of an operator. 

1. A handle for a flexible, elongated controllable tip spring guide having a tubular guide body and a core wire projecting from the proximal end of said guide body, said handle comrising: a hand grip located at a first, proximal end of the handle, said hand grip having circumferential and axial dimensions such that said hand grip can be held substantially within the palm of the hand of an operator; an intermediate assembly rotationally and non-slidably mounted in a generally coaxial relationship with the hand grip, the intermediate assembly including a core having at a first, proximal end thereof a cylindrical end portion rotatably engaged in the distal end of the hand grip, the core further having a middle block portion and a distal rod portion coaxial with the cylindrical end portion, the distal rod portion extending axially of the hand grip, the rod portion being longitudinally grooved, said block portion having a radially disposed hole in the plane of said groove, and said hole being connected to said groove by a slit narrower than the diameter of said hole whereby a lug on the end of one of said guide body and a core wire can be retained within said hole with the core wire passing through said slit and said groove; means on the intermediate assembly for retaining the spring guide along the axis of said handle such that the distal end of said spring guide extends beyond the distal end of the rod portion of the core; means mounted on said intermediate assembly for rotationally positioning said intermediate assembly; and, a slidable carriage slidably and non-rotationally mounted on the intermediate assembly so as to permit axial positioning of said carriage on said assembly, said slidable carriage having means for engaging the other one of said guide body and core wire.
 2. A handle according to claim 1 wherein at least one of said guide body and wire engaging means includes a radially open slot having wider and narrower portions.
 3. A handle according to claim 1 which includes, at its distal end, an adjuster element movable axially of the handle and provided with means for securement in different axially adjusted positions.
 4. A handle according to claim 1 wherein the means for positioning the intermediate assembly comprises a wheel-like member axially spaced from the hand grip so as to permit rotation of the wheel-like member by the thumb and forefinger of said operator.
 5. A handle according to claim 1 wherein the slidable carriage is non-rotatably mounted on the distal rod portion of the core.
 6. A handle according to claim 5 wherein the slidable carriage is provided with a longitudinal slot in register with the groove in the rod pOrtion, said slot terminating distally adjacent a slitted abutment adapted to bear against a lug on the proximal end of the tubular guide body.
 7. A handle according to claim 6 which includes an adjuster element slidable engaged with a distal end portion of the carriage and provided with means for securement in different axially adjusted positions.
 8. A handle assembly according to claim 1 and including means on the intermediate assembly for engaging one of said guide body and core wire.
 9. A handle for a flexible, elongated controllable tip spring guide having a tubular guide body and a core wire projecting from the proximal end of said guide body, said handle comprising: a hand grip located at a first, proximal end of the handle, said hand grip having circumferential and axial dimensions such that said hand grip can be held substantially within the palm of the hand of an operator; an intermediate assembly including a mounting plug rotationally and non-slidably mounted at a first, proximal end in a generally coaxial relationship at the distal end of said hand grip, the intermediate assembly further including a rod having a first, proximal end fixed in the second, distal end of said plug eccentrically thereof, the second, distal end of said rod extending axially beyond said plug and having mounted on said distal end a guide body mounting block, said guide body mounting block having means for providing a rigid attachment to said rod; means on the intermediate assembly for engaging one of said guide body and core wire; means on the intermediate assembly for retaining the spring guide along the axis of said handle such that the distal end of said spring guide extends beyond the distal end of said intermediate member; means mounted on the intermediate assembly for rotationally positioning said intermediate assembly; and, a slidable carriage slidably and non-rotatably mounted on the rod of the intermediate assembly between said plug and said guide body mounting block so as to permit axial positioning of said carriage on said assembly, the slidable carriage having means for engaging the other one of said guide body and core wire.
 10. A handle according to claim 9 wherein the guide body mounting block is traversed from end to end by a slot.
 11. A handle according to claim 10 wherein said slot is formed with an enlarged chamber to receive the proximal end fitting of a guide body, said chamber being bounded proximally and distally by narrowed parts of said slot adapted to restrain said fitting from axial movement out of said chamber.
 12. A handle according to claim 9 which includes a trigger fixed in said carriage and projecting therefrom, said trigger being shaped and positioned for convenient operation by the operator''s finger to slide the carriage axially toward or away from the hand grip.
 13. A handle according to claim 9 in which the guide body mounting block is formed with a distally extending portion, said adjuster element being provided with means for securement in different axially adjusted positions.
 14. A handle according to claim 9 wherein the means for positioning the intermediate assembly comprises a wheel-like member axially spaced from the hand grip so as to permit rotation of the wheel-like member by the thumb and forefinger of an operator. 